Defining covid-19 elimination

The impact of COVID-19 prevention and control policy adjustment on anxiety, depression and coping behavior in China: a cross-sectional online survey, 21-28 December, 2022

BACKGROUND

Following external situation reports, individuals perceive risks, experience different emotional reactions, and further change their behaviors. Therefor people's psychology will also be affected by adjustment of COVID-19 epidemic prevention and control policy, but it remains unknown what kind of coping behaviors will be produced due to psychology. This study defines coping behavior as "medical behavior and irrational consumption behavior after the adjustment of COVID-19 epidemic prevention and control policy in China", assesses the prevalence of negative emotions in the Chinese population after policy adjustments, and explores how negative emotions affect people's coping behaviors, conducts baseline research, provides references and suggestions for policy formulation.

METHODS

A cross-sectional online survey was conducted during 21-28 December 2022, included sociodemographic characteristics, COVID-19 infection and irrational purchase behavior, psychological assessment, and opinion polling. Depression and anxiety status are assessed by PHQ-9 and GAD-7. The relationship between anxiety, depression and coping behavior was analyzed by Pearson χ2 test, Fisher's exact test and logistic regression.

RESULTS

A total of 3995 infected participants were included in this study, of which 2363(59.1%) and 1194(29.9%) had depression and anxiety. There was a significant difference in clinical treatment and irrational purchase behavior between different level of depression and anxiety. Depression was a risk factor for self- medication (OR = 1.254), seeking professional treatment (OR = 1.215), using online services of medical institutions (OR = 1.320), large-scale purchases of medicines (OR = 1.154) and masks (OR = 1.096). Anxiety was a risk factor for seeking professional treatment (OR = 1.285) and large-scale purchases of masks (OR = 1.168).

CONCLUSION

After the adjustment of COVID-19 epidemic prevention and control policy, patient risk perception can increase depression and anxiety. We found that associated with depression, COVID-19 patients are more likely to have medical behaviors such as self- medication, seeking professional treatment, using online services of medical institutions, and storage behaviors of medicines and masks; and anxiety associated with the coping behavior of patients to seek professional treatment and store masks in large quantities. We should improve people's mental health, and on the other hand, we should give people effective psychological education during the epidemic. Therefore, we should set up psychological outpatient clinics in community health institutions, expanding mental health screening and guidance; relying on the psychological outpatient clinic, establish groups of people with depression or anxiety to carry out COVID-19 health education and peer education, to reduce adverse drug reactions, avoid panic seeking professional treatment and irrational purchase behavior, and protect public mental health.

TRIAL REGISTRATION

This study has been approved by the Medical Ethics Committee of Capital Medical University (2023SY086), and informed consent was obtained from the study subjects before the investigation.

The shift of percent excess mortality from zero-COVID policy to living-with-COVID policy in Singapore, South Korea, Australia, New Zealand and Hong Kong SAR

Introduction

With the economic recession and pandemic fatigue, milder viral variants and higher vaccine coverage along the time lay the basis for lifting anti-COVID policies to restore COVID-19 normalcy. However, when and how to adjust the anti-COVID policies remain under debate in many countries.

Methods

In this study, four countries (Singapore, South Korea, Australia, and New Zealand) and one region (Hong Kong SAR), that have shifted from the zero-COVID (ZC) policy to or close to the living-with-COVID (LWC) during or after the Omicron outbreak, were selected as research objects. All-cause mortality data were collected for these objects from 2009 to 2019. The expected mortality was estimated by a simple linear regression method. Excess mortality over time was calculated as the difference between the expected mortality and the observed mortality. Finally, percent excess mortality (PEM) was calculated as the excess mortality divided by the expected mortality.

Results

In the examined four countries, PEM fluctuated around 0% and was lower than 10% most of the time under the ZC policy before 2022. After shifting to the LWC policy, all the examined countries increased the PEM. Briefly, countries with high population density (Singapore and South Korea) experienced an average PEM of 20-40% during the first half of 2022, and followed by a lower average PEM of 15-18% during the second half of 2022. For countries with low population density under the LWC policy, Australia experienced an average PEM of 39.85% during the first half of 2022, while New Zealand was the only country in our analysis that achieved no more than 10% in average PEM all the time. On the contrary, Hong Kong SAR under their ZC policy attained an average PEM of 71.14% during the first half of 2022, while its average PEM decreased to 9.19% in the second half of 2022 with LWC-like policy.

Conclusion

PEM under different policies within each country/region overtime demonstrated that the mortality burden caused by COVID-19 had been reduced overtime. Moreover, anti-COVID policies are suggested to control the excess mortality to achieve as low as 10% in PEM.

The danger of the single storyline obfuscating the complexities of managing SARS-CoV-2/COVID-19

Chimamanda Ngozi Adichie showed how a single story is limited and thereby distorts the true nature of an issue. During this COVID-19 pandemic there have been, at least, three consecutive single stories-the 'lethal threat' story, followed by the 'economic threat' story, and finally the 'vaccine miracle' story. None of these single stories can convincingly and permanently capture the dynamics of the pandemic. This is because countries experienced different morbidity and mortality patterns, different socioeconomic disadvantage, age and vulnerability of population, timing and level of lockdown with economic variability, and, despite heavy promotion, vaccines were beset with a significant and variable degree of hesitancy. Lack of transparency, coherence and consistency of pandemic management-arising from holding on to single storylines-showed the global deficiency of public health policy and planning, an underfunding of (public) health and social services, and a growing distrust in governments' ability to manage crises effectively. Indeed, the global management has increased already large inequities, and little has been learnt to address the growing crises of more infectious and potentially more lethal virus mutations. Holding onto single stories prevents the necessary learnings to understand and manage the complexities of 'wicked' problems, whereas listening to the many stories provides insights and pathways to do so effectively as well as efficiently.

Trends in Confirmed COVID-19 Cases in the Korean Military Before and After the Emergence of the Omicron Variant

BACKGROUND

Due to the higher transmissibility and increased immune escape of the omicron variant of severe acute respiratory syndrome coronavirus 2, the number of patients with coronavirus disease 2019 (COVID-19) has skyrocketed in the Republic of Korea. Here, we analyzed the change in trend of the number of confirmed COVID-19 cases in the Korean military after the emergence of the omicron variant on December 5, 2021.

METHODS

An interrupted time-series analysis was performed of the daily number of newly confirmed COVID-19 cases in the Korean military from September 1, 2021 to April 10, 2022, before and after the emergence of the omicron variant. Moreover, the daily number of newly confirmed COVID-19 cases in the Korean military and in the population of Korean civilians adjusted to the same with military were compared.

RESULTS

The trends of COVID-19 occurrence in the military after emergence of the omicron variant was significantly increased (regression coefficient, 23.071; 95% confidence interval, 16.122-30.020; P < 0.001). The COVID-19 incidence rate in the Korean military was lower than that in the civilians, but after the emergence of the omicron variant, the increased incidence rate in the military followed that of the civilian population.

CONCLUSION

The outbreak of the omicron variant occurred in the Korean military despite maintaining high vaccination coverage and intensive non-pharmacological interventions.

China's community-based crisis management model for COVID-19: A zero-tolerance approach

At present, the zero-tolerance and co-existence approaches are the two basic concepts used to manage COVID-19. With the increase in vaccination rates and the continuing impact of the pandemic on people's lives, the co-existence approach has become the mainstream global practice. However, its high infection rate is still an inevitable fact. China was the first country to adopt the zero-tolerance approach to deal with COVID-19 and successfully control it. Due to its immediate effects and low infection rates, this approach has been used in China until now. Through the co-operation of the government and community, China has achieved precise regional lockdowns and patient identification. This article uses the CBCM model to interpret how China has achieved its zero-tolerance approach. Finally, the secondary hazards and applicability of China's CBCM model are discussed. This article draws the following conclusions: (1) China's CBCM basically replicates Singapore's crisis management model for SARS. With the co-operation of the community, it achieved universal coverage of prevention, detection and control; (2) Government leadership in dealing with major crises is very important; (3) In addition to relying on the extreme power of the government to realize China's CBCM model, the two major factors of a submissive society and collectivism have played an important role; (4) China's CBCM model is essentially an excessive anti-pandemic strategy.

The Advantages of the Zero-COVID-19 Strategy

Introduction: To curb the COVID-19 pandemic, countries across the globe have adopted either a mitigation or anelimination policy, such as the zero-COVID-19 strategy. However, further research is needed to systematically investigate the advantages of the zero-COVID-19 strategy in the literature. To bridge the research gap, this study examines the zero-COVID-19 strategy in terms of its advantages as a global anti-pandemic framework. Methods: A literature review was conducted in PubMed, PsycINFO, and Scopus to locate academic articles that discussed the advantages of the zero-COVID-19 strategy. Braun and Clarke’s thematic analysis approach was adopted to guide the data analysis process. Results: The findings of our study show that the advantages of the zero-COVID-19 strategy range from short-term (e.g., limited virus infections, hospitalizations, and deaths), to medium-term (e.g., reduced presence of other infectious diseases), and long-term (e.g., low incidence of long COVID-19). While local residents mainly leverage these advantages, they also impact the global community (e.g., stable global supply of essentials, such as COVID-19 vaccines). Conclusions: COVID-19 is catastrophic, yet controllable. Our study examined the advantages of the zero-COVID-19 strategy from a nuanced perspective and discussed how these advantages benefit both the local and the global community in pandemic control and management. Future studies could investigate the shortcomings of the zero-COVID-19 strategy, especially its unintended consequences, such as adverse impacts on vulnerable populations’ mental health, so that society could more efficiently, economically, and empathetically capitalize on the potential of the zero-COVID-19 strategy for the betterment of personal and public health.

Pathways and obstacles to social recovery following the elimination of SARS-CoV-2 from Aotearoa New Zealand: a qualitative cross-sectional study

BACKGROUND

Many public health experts have claimed that elimination strategies of pandemic response allow 'normal social life' to resume. Recognizing that social connections and feelings of normality are important for public health, this study examines whether, and for whom, that goal is realized, and identifies obstacles that may inhibit its achievement.

METHODS

Thematic analysis of narratives obtained via a qualitative cross-sectional survey of a community cohort in Aotearoa | New Zealand.

RESULTS

A majority of participants reported that life after elimination was 'more or less the same' as before the pandemic. Some became more social. Nevertheless, a sizeable minority reported being less social, even many months after elimination. Key obstacles to social recovery included fears that the virus was circulating undetected and the enduring impact of lockdowns upon social relationships, personal habits and mental health. Within our sample, old age and underlying health conditions were both associated with a propensity to become less social.

CONCLUSIONS

Elimination strategies can successfully allow 'normal social life' to resume. However, this outcome is not guaranteed. People may encounter difficulties with re-establishing social connections in Zero-COVID settings. Measures designed to overcome such obstacles should be an integral part of elimination strategies.

Living through the COVID-19 Pandemic: Impact and Lessons on Dietary Behavior and Physical Well-Being

The aim of this review is to highlight the spectrum on which human behavior has been affected by blanket restriction measures and on a wider scale, the COVID-19 pandemic. Some of the human behaviors that have been impacted by the COVID-19 lockdown are dietary behavior and nutrition, food options and food delivery usage, physical activity and sedentary behaviors. This is important in planning effective public health strategies with minimal detriment to all subsets of society as well as improving the distribution of government aid to populations that are more severely affected. Our main purpose is to present the literature from a rapidly growing pool of scientific research to hopefully enable a better and more comprehensive understanding of the effects of this pandemic and the lessons learnt from the accompanying restrictions, as well as policy recommendations that can be made in national pandemic responses in the future.